North York General Hospital (NYGH) is a community academic centre that sees over 1400 patients for hip and knee joint replacement surgery. The Integrated Care Collaborative (ICC) program for hip and knee replacement surgery offers patient- and family-centred care in a coordinated fashion from the moment a patient is referred to a specialist through the hospital stay to recovery.

With the leadership of a patient navigator – a clinical nurse specialist who manages pre-identified patients from referral to rehabilitation – patients are ensured excellent patient experience and outcomes through seamless, integrated hip and knee replacement care.

Adapted from an evidence-based model created by Michael Porter of Harvard University, the Hip and Knee ICC program involves collaboration amongst the inter-professional team of physicians, nurses, allied health, other health professionals, administrators and community partners who partner with the patients and their families to streamline their surgical experience and ensure that they receive the best, most comprehensive care from diagnosis to rehabilitation.

The ICC program is one of NYGH’s proudest achievements, one that is changing the way care is delivered elsewhere in the hospital. This innovative endeavour has enabled us to improve on all provincial targets and decrease our costs, saving more than $933,000 since the inception of the program. We have sustained those results for more than two years while staying focused and centred on our patients and their families. Our patients have voiced their satisfaction through our NRCC Picker surveys, where the satisfaction for overall care received is rated at 96%, a 6% improvement since the ICC’s debut.

Patient navigators exist primarily in cancer care. It was innovative to implement one in orthopaedics. It relates to our aging population in our LHIN and growing need to support this demographic, especially since we are a high volume joint centre. Supporting patient navigation is a key component of NYGH's Hip and Knee Integrated Care Collaborative (ICC) – a new holistic model of care that weaves together quality improvement steps to improve patient outcomes and deliver better value.

Contact Information:

Title: Program Director, Surgery

Contact information: Linda.Jussaume@nygh.on.ca

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